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Prescriptions for controlled-release oxycodone, a narcotic analgesic, recently contributed to a dramatic increase in pharmacy costs for a large private insurance company. To determine whether this agent offered clinical benefits over other available drugs that would justify its significantly greater cost, a systematic review of 16 clinical trials was undertaken. The review suggested that immediate-release and controlled-release preparations of oxycodone have similar efficacy and comparable side effect profiles. Controlled-release oxycodone has the advantage of less frequent dosing than immediate-release oxycodone; however, other agents may be dosed infrequently at much lower costs. For patients requiring a controlled-release opioid treatment, controlled-release morphine and methadone should be considered because they appear to be as effective as oxycodone and cost considerably less. Controlled-release oxycodone may be appropriate for some patients, particularly if they cannot tolerate other controlled-release or long-acting opioid analgesics.

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Although child labor laws are designed to protect youth from serious injury in the workplace, there are a number of other factors that influence the effectiveness of occupational injury prevention including adolescent risk perception, failure to understand worker rights, and lack of experience. The growing adolescent Hispanic population in the U.S. is of particular concern because cultural and economic barriers have the potential to further influence these young workers' safety. A greater emphasis on research among Hispanic adolescents is crucial to minimizing adolescent worker injury. To propose effective age and culturally appropriate intervention programs, it will be necessary to understand the knowledge, attitude and beliefs regarding occupational risks within the workingadolescent Hispanic community.